One reason is poor pay for very hard work. Another is lack of respect in our society for those who do "service" oriented work, particularly those who do the hands on work such as Certified Nursing Assistants (CNA) - the very people you want to be "the best" when it comes to daily care of your loved one.

Another interesting aspect, from the Family Caregiver Alliance -- non-professionals who are thrust into the role of caring for a family member are extremely likely to suffer depression.

One of today's all-too silent health crises is caregiver depression. A conservative estimate reports that 20 percent of family caregivers suffer from depression, twice the rate of the general population.

My sense is that corporate American has begun to take depression more seriously. The report cites research showing that depression costs companies more than $30 billion annually in lost productivity.

Managers and supervisors should be trained to be alert for changes in job performance that may reflect common symptoms of depression. While it's not a manager's role to be a counselor, managers are in a position to refer an employee to professionals such as an EAP who can help to discover the underlying reason for the change in performance.